scholarly journals Study of evaluation of Alvarado scoring system in acute appendicitis

2019 ◽  
Vol 7 (1) ◽  
pp. 64
Author(s):  
Shashidhara Puttaraju ◽  
Deva Keerthana D. Y.
Keyword(s):  
Acute Appendicitis ◽  
Scoring System ◽  
Surgical Techniques ◽  
Clinical Decision ◽  
Alvarado Score ◽  
Suspected Appendicitis ◽  
Diagnostic Modalities ◽  
Surgery Department ◽  
High Degree ◽  
Union Territory

Background: Acute appendicitis is one of the most common surgically correctable acute abdomen presenting at emergency department worldwide. Inspite of all advances in diagnostic modalities and surgical techniques, diagnosis remains difficult sometimes as a challenge and delayed decision making complicates this surgical disease. Alvarado scoring system is one of available scoring system for diagnosis of acute appendicitis, based on history, clinical examination, lab investigations and easy to apply, helps in clinical decision regarding planning surgery and avoid negative laparotomies. The aim of the study was to evaluate diagnostic accuracy of Alvarado scoring system in preoperative diagnosis of acute appendicitis and correlating with postoperative findings.Methods: This study was conducted in 100 cases of suspected appendicitis admitted in surgery department of Rajiv Gandhi Speciality Hospital, Agatti Island, Lakshadweep, Union territory of India, from July 2015 to June 2017 adopting Alvarado scoring system. Results were analyzed.Results: Out of 100 patients admitted with suspected acute appendicitis, number of cases operated suspecting acute appendicitis were 83 of which 80 were found to have acutely inflamed appendix. Results of Alvarado score of operated patients are as follows: 80 patients had score 7-10, and 3 patients had score 5-6, patients with Alvarado score <5 (17 pts) were managed conservatively.Conclusions: The Alvarado scoring system is a simple and useful diagnostic tool for diagnosis of acute appendicitis with acceptable sensitivity and specificity and can be used with high degree of accuracy. Our findings suggest that patients presenting with abdominal pain and Alvarado scores greater than 7 are more likely to have appendicitis.

scholarly journals A three year prospective study-suspected acute appendicitis: diagnostic accuracy of modified Alvarado score versus ultrasonography in adults

2017 ◽  
Vol 4 (12) ◽  
pp. 3924
Author(s):  
Murhari D. Gaikwad ◽  
Anand Auti ◽  
Avinash Magare
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Prospective Study ◽  
Predictive Value ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Alvarado Score ◽  
Suspected Appendicitis ◽  
Modified Alvarado Score ◽  
Suspected Acute Appendicitis

Background: To evaluate and compare diagnostic accuracy of modified Alvarado score and ultrasonography in co-relation to histopathology report for diagnosis of acute appendicitis.Methods: A prospective study of the patients who underwent appendectomy for suspected acute appendicitis at IIMS and R Medical College and Noor Hospital Warudi, Badnapur, Dist. Jalna (Maharashtra). The clinical (radiological) and ultrasonography data of 760 patients with suspected appendicitis was collected between March 2014 to Feb. 2017. These patients were evaluated by modified Alvarado score and ultrasonographically, which was corrected with histopathological finding.Results: Out of 760 patients 69.34% had acute appendicitis 63.81% had modified Alvarado score≥7 and 58.28% patients were ultrasonographically positive. In present study modified Alvarado score has sensitivity of 89.37% specificity 93.99% positive predictive value 97.11%, negative predictive value 79.64%, diagnostic accuracy of 81.32%.Conclusions: Modified Alvarado score can be used effectively in clinical decision making. When compare with ultrasonography neither one is advantageous. However, additional information provided by ultrasonography improves diagnostic accuracy.

Evaluation of the Appendicitis Inflammatory Response Score against Alvarado Score in Diagnosis of Acute Appendicitis

2020 ◽  
Vol 18 (2) ◽  
pp. 68-72
Author(s):  
O.B. Karki ◽  
N.K. Hazra
Keyword(s):  
Inflammatory Response ◽  
Acute Appendicitis ◽  
Scoring System ◽  
Receiver Operating Curve ◽  
P Value ◽  
Diagnostic Challenge ◽  
Alvarado Score ◽  
Predictive Values ◽  
Suspected Appendicitis ◽  
Response Score

Background Patients presenting with suspected appendicitis pose a diagnostic challenge. Various scoring systems have been designed to aid in the clinical assessment of these patients. Widely applied was Alvarado score and best performed in validating studies, but was observed with few drawbacks. Appendicitis inflammatory response (AIR) score was designed to overcome the drawbacks associated with the implementation of Alvarado scoring system. Objective The main objective of this study was to evaluate the Appendicitis inflammatory Response Score and compare its performance in predicting risk of appendicitis with the Alvarado score. Method Appendicitis inflammatory response score and Alvarado scores were calculated prospectively on patients suspected of acute appendicitis presenting to Manipal Teaching Hospital, Pokhara, Nepal between July 2017 and June 2019. Diagnostic performance of the two scores was compared. Statistical analysis was done using SPSS 21 and p value < 0.05 was considered significant. Result The study included 217 patients with 109 (50.2%) males and 108 (49.8%) females. The mean age of patients was 25.77±15.54. The results analyzed showed better sensitivity of Appendicitis Inflammatory Response score (96.91%) as compared to 94.30% of Alvarado score. The positive and negative predictive values of Alvarado score were 74.87% and 50%, as compared to 79.70% and 72.20% for AIR score. Furthermore, the area under receiver operating curve of the appendix inflammatory response score was better (0.701) than that of Alvarado score (0.580). Conclusion Appendicitis Inflammatory Response (AIR) scoring performed well and more accurate than Alvarado scoring system with high specificity and high negative predictive value preventing negative appendectomies.

scholarly journals VALIDITY OF ALVARADO SCORING SYSTEM IN DIAGNOSIS OF ACUTE APPENDICITIS

1969 ◽  
Vol 5 (2) ◽  
pp. 663-666
Author(s):  
ASGHAR ALI ◽  
ABDUR RAHMAN ◽  
FAZAL RAHIM
Keyword(s):  
Acute Appendicitis ◽  
Scoring System ◽  
Iliac Fossa ◽  
Cross Sectional Study ◽  
Alvarado Score ◽  
Cross Sectional ◽  
Female Ratio ◽  
Suspected Appendicitis ◽  
Surgical Ward ◽  
Male To Female

BACKGROUND: The first appendectomy was performed by Claudius Amyand in 1736 when he wasoperating on a boy for hernia and found appendix lying in hernial sac. Reginald Fitz introduced the wordappendicitis in 1886 and before that it was called typhlitis or perityphlitis.Frederick Treves performedthe lstappendicle surgery in England for the new disease ‘appendicitis’ in 1887.OBJECTIVE: To study the accuracy of modified Alvarado scorning system in diagnosis of acuteappendicitis.MATERIAL & METHODS: This descriptive cross sectional study was conducted at DHQ HospitalTimergara Dir lower from January 2015 to July 2015 to find out the accuracy of Alvarado Scoringsystem in the diagnoses of acute appendicitis. A total of 50 patients admitted in surgical ward from OPDand Casualty with suspected appendicitis were included in the study. Patients less than 7 years andpatients with mass right iliac fossa were excluded. Every patient was evaluated with modified Alvaradoscoring system on a standard Proforma. Patients with Alvarado score of > 6 underwent appendectomy.The removed appendices were sent for histopathology to confirm or otherwise the provisional diagnosisof acute appendicitis and hence the accuracy of Alvarado scoring system.RESULTS: Out of 50 patients, 20 were male &30 were female with a male to female ratio of 1:1.5. Themean age of the patients was 19.7 ± 9.6years. The mean Alvarado score was 7.92 ± 1.383. TheHistopathology reports of the specimens of 37 patients were confirmative of acute appendicitis whereasthe rest of the (13 patients) removed appendices were reported normal by histopathalogist. So thesensitivity is 74%.CONCLUSION: Our study shows that Alvarado scoring system is a simple and quick tool in theevaluation and management of suspected cases of acute appendicitis. Its accuracy increases if used inpatients above 14 years of age.KEYWORD: Alvarado scoring system, Appendicitis, Accuracy.

scholarly journals Diagnostic accuracy of acute appendicitis by comparing clinical judgment of surgeons and Alvarado scoring in suspected acute appendicitis

2021 ◽  
Vol 8 (9) ◽  
pp. 2725
Author(s):  
Ishory Bhusal ◽  
Chandra Shekhar Agarwal ◽  
Rakesh Kumar Gupta ◽  
Suresh Prasad Sah
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Clinical Judgment ◽  
Scoring System ◽  
Randomized Study ◽  
Tertiary Hospital ◽  
Alvarado Score ◽  
Suspected Appendicitis ◽  
Group A ◽  
Group B

Background: The Alvarado score is a clinical scoring system used in the diagnosis of acute appendicitis. The aim of the study was to compare the clinical judgment of surgeons and Alvarado score in diagnosing acute appendicitis within Nepalese people and to refine the score and suggest a new score to make a more accurate diagnosis of acute appendicitis.Methods: In this prospective, parallel-group, quasi-randomized study of patients presenting at a tertiary hospital in eastern Nepal with suspected appendicitis during 1 year were assigned in weekly alternation to either group A or group B. The group A patients were treated on the basis of their Alvarado score, and the group B patients based on the clinical judgment. The correctness of the methods was assessed by the final histology.Results: In this study, the mean age of patients in Alvarado group was 26.45 years and in clinical judgment was 28.68 years. The sensitivity, the specificity, the diagnostic accuracy, the positive predictive value and negative appendectomies in Alvarado group were 95.5%, 68.9%, 90.91%, 93.4% and 6.56% respectively whereas in clinical judgment group were 98.51%, 85.71%,496.4%, 97.04% and 3.59% respectively.Conclusions: This study showed clinical judgment to be more reliable in the diagnosis of acute appendicitis than the Alvarado score, but the score is a useful diagnostic aid, especially for young colleagues. The use of the new scoring system has become easier. It includes fewer criteria as well as an important and sensitive predictor: the ultrasound investigation.

“A COMPARATIVE STUDY OF RIPASA SCORE AND ALVARADO SCORE IN THE DIAGNOSIS OF ACUTE APPENDICITIS”

2021 ◽  
pp. 25-28
Author(s):  
M. Vijaya Kumar ◽  
Manasa Manasa
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Scoring System ◽  
Local Population ◽  
Scoring Systems ◽  
Signs And Symptoms ◽  
Alvarado Score ◽  
Predictive Values ◽  
Ripasa Score

Acute appendicitis is the most common condition encountered in the Emergency department .Alvarado and Modied Alvarado scores are the most commonly used scoring system used for diagnosing acute appendicitis.,but its performance has been found to be poor in certain population . Hence our aim was to compare the diagnostic accuracy of RIPASA and ALVARADO Scoring system and study and compare sensitivity, specicity and predictive values of these scoring systems. The study was conducted in Government district hospital Nandyal . We enrolled 176 patients who presented with RIF pain . Both RIPASA and ALVARADO were applied to them. Final diagnosis was conrmed either by CT scan, intra operative nding or post operative HPE report. Sensitivity,specicity, positive predictive value, negative predictive value, diagnostic accuracy was calculated both for RIPASA and ALVARADO. It was found that sensitivity and specicity of the RIPASA score in our study are 98.7% and 83.3%, respectively. PPV and NPV were 98.1% and 88.2% and sensitivity and specicity of the Alvardo score in our study are 94.3% and 83.3%, respectively. PPV and NPV were 98% and 62.5%.Diagnostic accuracy of RIPASA score and Alvarado score are 97% and 93% respectively. RIPASA is a more specic and accurate scoring system in our local population when compared to ALVARADO . It reduces the number of missed appendicitis cases and also convincingly lters out the group of patients that would need a CT scan for diagnosis (score 5-7.5 ) BACKGROUND: Acute appendicitis is one of the most commonly dealt surgical emergencies, with a lifetime prevalence rate of approximately 1 one in seven. The incidence is 1.5–1.9 per 1,000 in the male and female population, and is approximately 1.4 times greater in men than in women. Despite being a common problem, it remains a difcult diagnosis to establish, particularly among the young, the elderly and females of reproductive age, where a host of other genitourinary and gynaecological inammatory conditions can present with signs and symptoms that are 2 similar to those of acute appendicitis. A delay in performing an appendectomy in order to improve its diagnostic accuracy increases the risk of appendicular perforation and peritonitis, which in turn increases morbidity and mortality. A variable combination of clinical signs and symptoms has been used together with laboratory ndings in several scoring systems proposed for suggesting the probability of Acute Appendicitis and the possible subsequent management pathway. The Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and ALVARADO score are new diagnostic scoring systems developed for the diagnosis of Acute Appendicitis and has been shown to have signicantly higher sensitivity, specicity and diagnostic accuracy. AIMS AND OBJECTIVES PRIMARY OBJECT 1. To compare RIPASA Scoring system and ALVARADO Scoring system in terms of diagnostic accuracy in Acute Appendicitis. 2. To study and compare sensitivity, specicity and predictive values of above scoring systems. SECONDARY OBJECT 1. To study the rate of negative appendicectomy based on above scoring systems. CONCLUSION: The RIPASA score is a simple scoring system with high sensitivity and specicity for the diagnosis of acute appendicitis. The 14 clinical parameters are all present in a good clinical history and examination and can be easily and quickly applied. Therefore, a decision on the management can be made early. Although the RIPASA score was developed for the local population of Brunei, we believe that it should be applicable to other regions. The RIPASA score presents greater Diagnostic accuracy and Sensitivity and equal specicity as a diagnostic test compared to the Alvarado score and is helpful in making appropriate therapeutic decisions. In hospitals like ours, the diagnosis of AA relies greatly on the clinical evaluation performed by surgeons. An adequate clinical scoring system would avoid diagnostic errors, maintaining a satisfactory low rate of negative appendectomies by adequate patient stratication, while limiting patient exposure to ionizing radiation, since 21 there is an increased risk of developing cancer with computed tomography, particularly for the paediatric age group.

scholarly journals Clinico-pathological and etiological evaluation of acute appendicitis and assessment of significance of laboratory and ultrasonography examination as an ancillary aid to clinical diagnosis

2019 ◽  
Vol 6 (6) ◽  
pp. 1954
Author(s):  
Sailendra Nath Paul ◽  
Dilip Kumar Das
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Scoring System ◽  
Clinical Symptoms ◽  
Lower Abdominal Pain ◽  
Complication Rates ◽  
Alvarado Score ◽  
Negative Appendicectomy ◽  
Operative Findings

Background: Timely diagnosis and intervention of acute appendicitis reduces morbidity and mortality associated with the disease condition. The study aimed to evaluate the etiology of acute appendicitis, to analyze the sensitivity of modified Alvarado scoring system and radiology in the diagnosis of acute appendicitis and to correlate the observations of laboratory tests, operative findings with the histopathological report of specimen of appendix.Methods: This was a prospective study done on 100 patients with clinical symptoms of acute right lower abdominal pain suggestive of appendicular origin during the period from February 2015 to January 2016 in the department of surgery thorough clinical assessment, laboratory investigations, ultrasound findings as were done for all patients. After confirming the diagnosis of AA the patients had operative intervention and specimens were sent for histopathological study.Results: Male preponderance was seen in the study. Majority of them belongs to 21 to 30 years age group (50%). Faecolith was the most common etiological factor observed (58%). Abdominal pain (100%) was the most common clinical symptom. Alvarado score had sensitivity of 95.74% and specificity of 66.67% in diagnosing AA. In correlation to histopathological findings, ultrasonography findings showed 100% positive visualization rate in all 71 cases. Elevated ESR (94%) had high diagnostic accuracy as confirmed by HPE finding (96.81%) which is statistically significant (p<0.000).Conclusions: Alvarado scoring system, elevated ESR levels and USG findings of the appendix can be considered as adjuncts to clinically diagnose the AA, to improve the diagnostic accuracy thereby consequently the rate of negative appendicectomy can be reduced and thus decreases the complication rates.

sTREM-1 assessment as a diagnostic biomarker for suspected acute appendicitis in children

2019 ◽  
Author(s):  
Tal Taraboulos Klein ◽  
Elkana Kohn ◽  
Baruch Klin ◽  
Tomer Ziv-Baran ◽  
Eran Kozer ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Complete Blood Count ◽  
Surrogate Marker ◽  
Serum Levels ◽  
Alvarado Score ◽  
Suspected Appendicitis ◽  
Reactive Protein ◽  
Significant Difference ◽  
History Of ◽  
Suspected Acute Appendicitis

Abstract Background The typical history of acute appendicitis is observed in less than 60% of cases. Therefore, searching for a surrogate marker is mandatory. Our goal was to determine whether the soluble triggering receptor expressed on myeloid cells (sTREM-1) is an efficient biomarker for acute appendicitis. Methods sTREM-1 serum levels were measured in addition to carrying out routine diagnostic tests (urine dipstick, complete blood count and C- reactive protein) in children admitted to the Emergency Department with suspected appendicitis. Statistical analysis was performed in order to examine whether sTREM-1 was a significant predictor of appendicitis. Results Fifty three of 134 children enrolled in the study were diagnosed with appendicitis. There was no significant difference in serum sTREM-1 levels (p=0.111) between children with or without appendicitis. Leukocytes, neutrophils and CRP were significantly elevated in the appendicitis group (p<0.001). The appendix diameter was significantly larger and the Alvarado score significantly higher in the appendicitis group (p<0.001). Conclusion serum sTREM-1 is not a good marker for acute appendicitis. Customary tests in addition to a proper patient history and physical examination are still the most effective methods to diagnose acute appendicitis.

scholarly journals ANGKA KEJADIAN APENDISITIS DI RSUP PROF. DR. R. D. KANDOU MANADO PERIODE OKTOBER 2012 – SEPTEMBER 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Gloria A. Thomas ◽  
Ishak Lahunduitan ◽  
Adrian Tangkilisan
Keyword(s):  
Acute Appendicitis ◽  
Acute Inflammation ◽  
Perforated Appendicitis ◽  
Vermiform Appendix ◽  
Clinical Decision ◽  
Chronic Appendicitis ◽  
Suspected Appendicitis ◽  
Male Patients ◽  
Using Data ◽  
Age Range

Abstract: Appendicitis is an inflammation of vermiform appendix. Acute inflammation of the appendix needs to be treated immediately to prevent fatal complications. The incidence among females and males is slightly comparable, however, the incidence is higher among males than females in the age range between 20-30 years. The fundamental clinical decision in the diagnosis of a patient with suspected appendicitis is whether to do an operation or not. The meaningful evaluation of acute appendicitis balances early operative intervention to prevent operative risks. This study aimed to obtain the incidence of appendicitis at Prof. Dr. R.D Kandou Hosiptal Manado from October 2012 to September 2015. This was a  retrospective descriptive study using data of the Department of Medical Record Prof. Dr. R.D Kandou Manado Hospital. The results showed that there were 650 patients. Most patients had acute appendicitis as many as 412 patients (63%) meanwhile chronic appendicitis was found in 38 patients (6%). Of 650 patients, 200 patients had complications; 193 patients (30%) with perforated appendicitis and 7 patients (1%) with appendicular mass. The most frequent age group to develop appendicitis was 20-29 years. The number of male patients was higher than the females. Keywords: appendicitis, incidence  Abstrak: Apendisitis adalah adanya peradangan pada apendiks vermiformis. Peradangan akut pada apendiks memerlukan tindak bedah segera untuk mencegah komplikasi yang umumnya berbahaya. Insidens pada perempuan dan laki-laki umumnya sebanding, kecuali pada umur 20-30 tahun insidens pada laki-laki lebih tinggi. Keputusan klinis mendasar dalam mendiagnosis pasien dengan dugaan apendisitis ialah apakah perlu dilakukannya operasi atau tidak.  Evaluasi yang baik dari kasus apendisitis akut dapat mengurangi intervensi untuk operasi awal, dengan harapan dapat mengurangi risiko operasi yang tidak diperlukan. Penelitian ini bertujuan untuk mengetahui angka kejadian apendisitis di RSUP Prof. Dr. R. D, Kandou Manado periode Oktober 2012 – September 2015. Metode penelitian yang digunakan ialah deskriptif retrospektif dengan menggunakan data di Bagian Rekam Medik RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian menunjukkan bahwa selama periode Oktober 2012 – September 2015 terdapat 650 pasien. Jumlah pasien terbanyak ialah apendisitis akut yaitu 412 pasien (63%) sedangkan apendisitis kronik sebanyak 38 pasien (6%). Dari 650 pasien, yang mengalami komplikasi sebanyak 200 pasien yang terdiri dari 193 pasien (30%) dengan komplikasi apendisitis perforasi dan 7 pasien (1%) dengan periapendikuler infiltrat. Kelompok umur tersering yang menderita apendisitis ialah 20-29 tahun. Jumlah pasien laki-laki lebih banyak daripada perempuan. Kata kunci: apendisitis, angka kejadian  

scholarly journals Diagnostic Accuracy of the Alvarado Scoring System in Patients Undergoing Appendicectomy at the University Teaching Hospital in Lusaka

2020 ◽  
Vol 4 (2) ◽  
pp. 21-28
Author(s):  
Songiso Mutumba ◽  
◽  
J Mulundika ◽  
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Teaching Hospital ◽  
Roc Curve ◽  
Scoring System ◽  
Area Under The Curve ◽  
University Teaching ◽  
Alvarado Score ◽  
Negative Case ◽  
The University

Background: The use of the Alvarado scoring system as a tool for diagnosing acute appendicitis has been associated with a reduction of negative appendicectomies. This study aimed to assess the diagnostic accuracy of the Alvarado scoring system at predicting acute appendicitis in patients undergoing appendicectomy at the University Teaching Hospital (UTH). Methods: A prospective study was done to evaluate the diagnostic value of the Alvarado score in patients undergoing appendicectomy at the UTH. Data was collected from the participants diagnosed with acute appendicitis and undergoing appendicectomy. The Alvarado scores for all the participants enrolled into the study were tabulated and correlated with the histopathology results. The sensitivity and the specificity of the Alvarado score was determined and used to construct the ROC curve using the SPSS version 20. The area under the curve was used to determine the diagnostic accuracy of the Alvarado score in this study. Setting: The University Teaching Hospital in Lusaka, Zambia. Results: To determine the diagnostic accuracy of the Alvarado score the ROC curve test was run in SPSS version 20. The results showed that the area under the curve was C=0.842 with SE=0.047 and 95% CI from 0.750 to 0.934. The area under the curve represents the probability that the Alvarado score result for a randomly chosen positive case will exceed the result for a randomly chosen negative case. It shows from the ROC that the Alvarado score is a good indicator to anticipate acute appendicitis. In other words, these results have confirmed that the Alvarado scoring system has very high predictive ability to discriminate acute appendicitis from normal appendix subjects. Conclusion: The use of the Alvarado scoring system as a tool for diagnosing acute appendicitis at UTH will reduce the rate of negative appendicectomies. This will lead to a reduction in unnecessary operations, which are a burden on the health care system.

scholarly journals Negative Appendectomy Rate in Urban Referral Hospitals in Tanzania: A Cross-sectional Analysis of Associated Factors

2021 ◽  
Vol 18 (2) ◽  
pp. 109-114
Author(s):  
Masawa Klint Nyamuryekung’E ◽  
Ali Athar ◽  
Miten Ramesh Patel ◽  
Aidan Njau ◽  
Omar Sherman ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Associated Factors ◽  
Lifetime Risk ◽  
Histological Evaluation ◽  
Negative Appendectomy ◽  
Perforation Rate ◽  
Alvarado Score ◽  
Suspected Appendicitis ◽  
Referral Hospitals ◽  
Negative Appendectomy Rate

Background: Acute appendicitis (AA) has a lifetime risk of 8.3% with a consequent 23% lifetime risk of emergency appendectomy. In atypical presentation, making a clinical diagnosis is difficult, leading to a high perforation rate (PR) or misdiagnoses and high negativeappendectomy rates (NAR). This study aimed to establish NAR and explore the associated factors and possible attainable solutions to reduce it in urban referral hospitals in Tanzania. Methods: This was a crosssectional study with 91 consecutive patients, aged 10 years and older undergoing appendectomy for  suspected AA with histological evaluation of specimens. The study was powered to detect the NAR at 95% confidence level and 80% power. Results: The histological NAR was 38.5% and the perforation rate was 25.3%. The Alvarado score (AS) was rarely applied (6%), despite ademonstrated ability in this study to decrease the NAR by half. Females were four times more likely to undergo negative appendectomy than males. Conclusion: The NAR is clinically significant as about two out of every five patients undergoing emergency appendectomy for suspected AA do not require the procedure. The AS is underutilized despite a demonstrated ability to decrease the NAR. We recommend that the AS be incorporated in the management of patients with suspected appendicitis. Keywords: Negative appendectomy rate, SubSaharan Africa, Alvarado score, Appendectomy, Suspected acute appendicitis

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